The incidence of periampullary cancer ranks the 8 th~9 th place among malignant tumors，but the fatality rate ranks the 4 th among tumor deaths. Due to the complex and varying anatomical characteristics of this area and the great diversity of lesions，imaging diagnosis and differential diagnosis have always been the focus and difficulty of clinical research. At present，a variety of imaging techniques are used to study the ampulla of Vater and its surrounding tissues，among which CT and MRI are the least invasive and the most widely used. This article reviews the recent progress in the identification of cancers using CT and MRI in the different classifications of periampullary carcinoma，the assessment of resectability，and the related prognosis.